Certainly the latter.

I have pretty decent insurance through work, but if I’m picking up a prescription, it’s cheaper for me to say I don’t have insurance and use a free discount card (like GoodRx) than to use my insurance. We’re talking $150-$200 for one prescription (a one month supply) with insurance vs $30 without.

To be fair, I have an HDHP with an HSA so my insurance is only supposed to negotiate a discount until I hit the deductible, rather than paying for it. Full price is $200-$250, I think? (I get generics and each generic variant has a slightly different price.) So technically they’re providing a discount, just not a very good one.

Insurance also likes to require a “prior authorization,” which was always a fun surprise after making it through the pharmacy line. That normally takes a couple days to resolve, at minimum, and sometimes longer. If you’re not familiar with prior auths, it’s basically when the insurance company says “Hey doc, can you justify why you’re prescribing this and answer these eight questions?” and then they have someone without a medical degree review the answer and see if it’s good enough.

The only downside to paying out of pocket with a discount card is that the $30 doesn’t go toward my deductible. But since my deductible is multiple thousands of dollars, unless something else happens during the year, I won’t hit my deductible off the $150-$200 prescriptions + regular doctor visits alone. But that’s at most $360 out of pocket that wouldn’t have gone toward the deductible, assuming I had a health crisis in December, vs $1440-$2040 saved if I don’t.

X-rays are even worse, because you’re not told the price ahead of time.

Some insurances are so bad you might as well not have it. Like if the deductible–which has to be paid in full before the insurance will touch most anything–is really high. A lot of the times they’re in the thousands, so yeah it’s cheaper to fly.

I agree this person really gets jokes before the fourth panel